Association between age of onset and mood in bipolar disorder: comparison of subgroups identified by cluster analysis and clinical observation

UMMS Affiliation

Department of Psychiatry

Publication Date


Document Type



Adolescent; Adult; *Affect; Age of Onset; Bipolar Disorder; Child; Cluster Analysis; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Longitudinal Studies; Male; Pain Measurement; Young Adult


Mental and Social Health | Psychiatry | Psychiatry and Psychology


BACKGROUND: This study compared subgroups identified by cluster analysis and clinical observation by evaluating the association between the age of onset of bipolar disorder and self-reported daily mood ratings.

METHODS: Two hundred and seventy patients with bipolar disorder provided daily self-reported mood ratings for about 6 months returning 55,188 days of data. The age of onset subgroups were determined both using previously defined cutoff values based upon clinical observation (29 years), and model-based cluster analysis. Demographic characteristics were compared in the age of onset subgroups. Univariate general linear models with age of onset subgroups and other demographic variables as fixed factors and covariates were used to analyze the percent of days depressed, euthymic and hypomanic/manic.

RESULTS: Using the predetermined subgroups, demographic differences were found between the four subgroups in the diagnosis of bipolar I/II, years of illness, age and use of lamotrigine. Post-hoc pairwise comparison found that patients with an age of onset less

CONCLUSION: Age of onset subgroups arising from clinical observation may be more useful than those determined by cluster analysis.

DOI of Published Version



J Psychiatr Res. 2010 Dec;44(16):1170-5. doi: 10.1016/j.jpsychires.2010.04.009. Link to article on publisher's site

Journal/Book/Conference Title

Journal of psychiatric research

Related Resources

Link to Article in PubMed

PubMed ID